Browsing by Author "Buis, Lorraine R"
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- ItemImproving Blood Pressure Among African Americans With Hypertension Using a Mobile Health Approach (the MI-BP App): Protocol for a Randomized Controlled Trial.(0000-00-00) Buis, Lorraine R; Dawood, Katee; Kadri, Reema; Dawood, Rachelle; Richardson, Caroline R; Djuric, Zora; Sen, Ananda; Plegue, Melissa; Hutton, David; Brody, Aaron; McNaughton, Candace D; Brook, Robert D; Levy, PhillipBACKGROUND African Americans shoulder significant disparities related to hypertension HTN which is a serious public health problem in the city of Detroit Michigan where more than 80 of the population is African American Connectivity through smartphones use of home blood pressure BP monitoring and newly developed mobile health mHealth interventions can facilitate behavioral changes and may improve long term self care for chronic conditions but implementation of a combined approach utilizing these methods has not been tested among African American patients with uncontrolled HTN Since African Americans are more likely than other racial or ethnic subgroups to utilize the emergency department ED for ambulatory care this presents an opportunity to intervene on a population that is otherwise difficult to reach OBJECTIVE The MI BP app aims to reduce health disparities related to HTN in the community by employing a user centered intervention focused on self BP monitoring physical activity reduced sodium intake and medication adherence We seek to test the efficacy of MI BP an mHealth app for HTN self management on BP control primary aim physical activity sodium intake and medication adherence secondary aim in African Americans with HTN This study also seeks to evaluate the cost effectiveness of MI BP when compared with usual care methods METHODS This is a 1 year randomized controlled trial that will recruit individuals who have uncontrolled HTN from 2 EDs in the city of Detroit with a planned sample size of 396 randomized participants To be eligible for inclusion potential participants must be African American 25 to 70 years old previously diagnosed with HTN have a smartphone compatible with MI BP and have uncontrolled BP at triage and on repeat measurement at least 1 hour post triage vitals Once a participant is deemed eligible all study procedures and subsequent follow up visits 8 in total are conducted at the Wayne State University Clinical Research Service Center We seek to determine the effect of MI BP on BP for 1 year using BP control and mean systolic BP as coprimary outcomes and physical activity sodium intake and medication adherence as secondary outcomes compared with usual care controls RESULTS Recruitment for this study began in January 2018 The study will continue through 2021 CONCLUSIONS As the first of its kind conducted in an ED setting MI BP was designed to document the efficacy and acceptability of a multicomponent mHealth approach to help African Americans with uncontrolled BP modify their lifestyle to better manage their HTN We expect to lay the foundation to sustainably reduce HTN related health disparities through better integration of multiple behavior self monitoring and improve outcomes for those who traditionally rely on the ED for chronic disease care TRIAL REGISTRATION ClinicalTrials gov NCT02360293 http clinicaltrials gov ct2 show NCT02360293 INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID RR1 10 2196 12601
- ItemText Messaging to Improve Hypertension Medication Adherence in African Americans: BPMED Intervention Development and Study Protocol.(2015-01-08) Buis, Lorraine R; Artinian, Nancy T; Schwiebert, Loren; Yarandi, Hossein; Levy, Phillip DBACKGROUND Hypertension HTN is a major public health concern in the United States with almost 78 million Americans age 20 years and over suffering from the condition Moreover HTN is a key risk factor for health disease and stroke African Americans disproportionately shoulder the burdens of HTN with greater prevalence disease severity earlier onset and more HTN related complications than age matched whites Medication adherence for the treatment of HTN is poor with estimates indicating that only about half of hypertensive patients are adherent to prescribed medication regimens Although no single intervention for improving medication adherence has emerged as superior to others text message medication reminders have the potential to help improve medication adherence in African Americans with uncontrolled HTN as mobile phone adoption is very high in this population OBJECTIVE The purpose of this two phased study was to develop Phase I and test in a randomized controlled trial RCT Phase II a text message system BPMED to improve the quality of medication management through increasing medication adherence in African Americans with uncontrolled HTN METHODS In Phase I we recruited 16 target end users from a primary care clinic to assist in the development of BPMED through participating in one of three focus groups Focus groups sought to gain patient perspectives on HTN medication adherence mobile phone use and the use of text messaging to support medication adherence Potential intervention designs were presented to participants and feedback on the designs was solicited In Phase II we conducted two pilot RCTs to determine the feasibility acceptability and preliminary efficacy of BPMED in primary care and emergency department settings Both pilot studies recruited approximately 60 participants who were randomized equally between usual care and the BPMED intervention RESULTS Although data collection is now complete data analysis from the two pilot RCTs is still ongoing and results are expected in 2015 CONCLUSIONS This study was designed to determine preliminary feasibility and acceptability of our approach among African Americans with uncontrolled HTN in primary care and emergency department settings Results from these studies are of great interest as little work has been done to document the use of text message medication reminders to improve HTN related outcomes particularly within underserved urban minorities TRIAL REGISTRATION Clinicaltrials gov NCT01465217 https clinicaltrials gov ct2 show NCT01465217 Archived by WebCite at http www webcitation org 6V0tto0lZ
- ItemUse of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part I): assessment of participant reach and adoption.(2013-12-20) Buis, Lorraine R; Hirzel, Lindsey; Turske, Scott A; Des Jardins, Terrisca R; Yarandi, Hossein; Bondurant, PatriciaBACKGROUND There are an estimated 25 8 million American children and adults equivalent to 8 3 of the US population living with diabetes Diabetes is particularly burdensome on minority populations The use of mobile technologies for reaching broad populations is a promising approach given its wide footprint and ability to deliver inexpensive personalized messages to increase awareness of type 2 diabetes and promote behavior changes targeting risk factors associated with type 2 diabetes As a part of the Beacon Community Cooperative Agreement Program txt4health a public facing mobile health information service was launched in 3 Beacon Communities the Southeast Michigan Beacon Community in Detroit MI the Greater Cincinnati Beacon Community in Cincinnati OH and the Crescent City Beacon Community in New Orleans LA Txt4health is a mobile health information service designed to help people understand their risk for type 2 diabetes and become more informed about the steps they can take to lead healthy lives OBJECTIVE The purpose of this investigation was to use the RE AIM framework to document txt4health reach and adoption by focusing on enrollment and participant engagement in program pilots in Southeast Michigan and Greater Cincinnati METHODS We conducted a retrospective records analysis of individual level txt4health system data from participants in Southeast Michigan and Greater Cincinnati to determine participant usage of txt4health and engagement with the program RESULTS Results from the retrospective records analysis revealed that 5570 participants initiated the 2 step enrollment process via 1 of 3 enrollment strategies text message website or directly with Beacon staff who signed participants up via the website In total 33 00 1838 5570 of participants completed the 2 step enrollment process and were fully enrolled in the program All participants 100 00 1620 1620 who enrolled via text message completed the entire 2 step enrollment process versus 5 52 218 3950 of participants who enrolled via website or a Beacon staff member Of those who fully enrolled 71 00 1305 1838 completed the diabetes risk assessment and 74 27 1365 1838 set an initial weight loss goal Overall 39 06 718 1838 of participants completed all 14 weeks of the program and 56 26 1034 1838 dropped out before completing all 14 weeks with the bulk of dropouts occurring in the first 4 weeks Length of participation varied greatly ranging from 0 48 7 weeks median 8 6 mean 15 8 SD 15 8 Wide variability of participant engagement in regards to weekly weight and physical activity was documented CONCLUSIONS Although broadly focused public health text message interventions may have the potential to reach large populations and show high levels of engagement among some users the level of individual engagement among participants varies widely suggesting that this type of approach may not be appropriate for all
- ItemUse of a text message program to raise type 2 diabetes risk awareness and promote health behavior change (part II): assessment of participants' perceptions on efficacy.(2013-12-20) Buis, Lorraine R; Hirzel, Lindsey; Turske, Scott A; Des Jardins, Terrisca R; Yarandi, Hossein; Bondurant, PatriciaBACKGROUND Although there is great enthusiasm in both the public and private sector for the further development and use of large scale consumer facing public health applications for mobile platforms little is known about user experience and satisfaction with this type of approach As a part of the Beacon Community Cooperative Agreement Program txt4health a public facing mobile phone based health information service targeting type 2 diabetes was launched in 3 Beacon Communities the Southeast Michigan Beacon Community in Detroit MI the Greater Cincinnati Beacon Community in Cincinnati OH and the Crescent City Beacon Community in New Orleans LA This program was marketed via large public health campaigns and drew many users within the respective communities OBJECTIVE The purpose of this investigation was to use the RE AIM framework to document txt4health efficacy by focusing on perceptions of satisfaction usage and behavior change among individuals who used txt4health in pilot studies in Southeast Michigan and Greater Cincinnati METHODS We conducted a multimodal user survey with txt4health users recruited via text message through the program to understand participant perceptions of program use and satisfaction as well as self reported perceptions of behavior change as a result of using txt4health RESULTS Txt4health users reported very high levels of program satisfaction with 67 1 108 161 reporting satisfaction scores of 8 on a 10 point scale with 10 equivalent to most satisfied mean 8 2 SD 1 6 All survey participants agreed strongly agreed that the messages included in txt4health were clear and easy to understand 100 0 160 160 and most found txt4health made them knowledgeable about their risk for type 2 diabetes 88 1 140 159 and made them conscious of their diet and physical activity 88 8 142 160 Most participants reported that txt4health helped them to make behavior changes related to diet after having completed txt4health most agreed strongly agreed that they are more likely to replace sugary drinks such as juice or soda with water 78 0 124 159 have a piece of fresh fruit instead of dessert 74 2 118 159 substitute a small salad for chips or fries when dining out 76 1 121 159 buy healthier foods when grocery shopping 79 7 126 158 and eat more grilled baked or broiled foods instead of fried 75 5 120 159 CONCLUSIONS Results from this study suggest that participants in txt4health a large scale public health focused text message program targeting type 2 diabetes have positive perceptions of the program and that participation has led to positive behavior change